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Johanna Eronen, Mikaela von Bonsdorff, Merja Rantakokko, Erja Portegijs, Anne Viljanen and Taina Rantanen

Life-space mobility describes the extent of community mobility of older persons. The aim of this cross-sectional study was to examine the relationship between socioeconomic status (SES) and life-space mobility and to investigate whether associations might be explained by SES-related disparities in health and functioning. The participants (n = 848) were community-dwelling adults aged 75–90. Education and occupation were used to indicate SES. Life-space assessment (range 0–120) was used to indicate distance and frequency of moving and assistance needed in moving. People with low education had lower life-space mobility scores than those with intermediate or high education: marginal means 63.5, 64.8, and 70.0 (p = .003), respectively. SES-related health disparities, i.e., higher body mass index, poorer cognitive capacity, and poorer physical performance explained the association, rendering it nonsignificant (marginal means 65.2, 65.3, and 67.5, p = .390). Low SES and restricted life-space mobility often coexist with overweight, reduced cognition, and poorer physical performance.

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Koji Yonemoto, Takanori Honda, Hiro Kishimoto, Daigo Yoshida, Jun Hata, Naoko Mukai, Mao Shibata, Yoichiro Hirakawa, Toshiharu Ninomiya and Shuzo Kumagai

Background: The purpose of this study was to describe changes in physical activity volumes and sedentary time over 3 years in the middle-aged and older Japanese population. Methods: Study participants included 1151 Japanese community-dwelling residents aged ≥40 years in 2009 who underwent 2 sets of health examinations (2009 and 2012). Using a triaxial accelerometer, longitudinal changes in sedentary time, light physical activity volume, moderate to vigorous physical activity volume, number of steps, and total physical activity volume were evaluated according to sex, age (40–49, 50–59, 60–69, 70–79, and ≥80 y), and obese (nonobese and obese) categories. Results: Sedentary time significantly increased, and all physical activity volumes significantly decreased among all participants. Although most variables did not change significantly in the 40–49 and 50–59 year age categories, similar changes as all participants were observed across all other categories. In the correlation analyses, changes in sedentary time correlated, at most, only modestly for each change in physical activity volumes, indicating that increased physical activity volume does not always lead to decreased sedentary time, and vice versa. Conclusions: Strategies to reduce sedentary time and promote physical activity are needed in Japan, particularly for people aged ≥60 years.

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K. John Fisher, Fuzhong Li, Yvonne Michael and Minot Cleveland

There is a need for greater understanding of setting-specific influences on physical activity to complement the predominant research paradigm of individual-centered influences on physical activity. In this study, the authors used a cross-sectional multilevel analysis to examine a range of neighborhood-level characteristics and the extent to which they were associated with variation in self-reported physical activity among older adults. The sample consisted of 582 community-dwelling residents age 65 years and older (M = 73.99 years, SD = 6.25) recruited from 56 neighborhoods in Portland, OR. Information collected from participants and neighborhood data from objective sources formed a two-level data structure. These hierarchical data (i.e., individuals nested within neighborhoods) were subjected to multilevel structural-equation-modeling analyses. Results showed that neighborhood social cohesion, in conjunction with other neighborhood-level factors, was significantly associated with increased levels of neighborhood physical activity. Overall, neighborhood-level variables jointly accounted for a substantial variation in neighborhood physical activity when controlling for individual-level variables.

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Jochen Klenk, Gisela Büchele, Ulrich Lindemann, Sabrina Kaufmann, Raphael Peter, Roman Laszlo, Susanne Kobel and Dietrich Rothenbacher

The aim of this study was to assess concurrent validity between activPAL and activPAL3 accelerometers in a sample of 53 community-dwelling older adults ≥ 65 years. Physical activity (PA) was measured simultaneously with activPAL and activPAL3 while performing scripted activities. The level of agreement between both devices was calculated for sitting/lying, standing, and walking. In addition, PA was measured over one week using activPAL to estimate the expected agreement with activPAL3 in real life. Overall agreement between activPAL and activPAL3 was 97%. Compared with activPAL, the largest disagreement was seen for standing, with 5% categorized as walking by activPAL3. For walking and sitting/lying, the disagreement was 2%, respectively. The expected daily differences between activPAL3 and activPAL were +15.0 min (95% CI: 11.3ߝ18.8) for walking and +29.5 min (95% CI: 6.2–52.7) for standing. ActivPAL and activPAL3 showed good agreement in older adults. However, if using these devices interchangeably, observed differences might still bias results.

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Liza Stathokostas and Gareth R. Jones

A convenience sample of 176 healthy, community-dwelling, inactive older adults (mean age 70 ± 5 years; 62 males, 114 females) were tracked for one year. The purpose was to describe the exercise modality choices older adults make one year following participation in an exercise and education intervention. Telephone follow-up contacted 137 participants (78%, men = 50, women = 87) and 62% of the men and 69% of the women reported to be “currently exercising.” Exercising independently was the most common type of exercise reported by 81% and 64% of men and women, respectively. Walking was the most commonly reported modality by both genders. The setting of exercise was most often reported to be at home or outside for both men and women. The main reason for continued participation at 12 months was for overall health (50% of men and 40% of women). Little variation was observed for exercise modality choice. Future interventions should consider a variety of exercise and physical activity opportunities for older adults.

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Jacqueline M. Miotto, Wojtek J. Chodzko-Zajko, Jennifer L. Reich and Melissa M. Supler

A limiting factor in evaluating the functional status of older people is the lack of appropriate measurement tools for assessing functional mobility, muscle strength, aerobic endurance, agility, and flexibility. In this study, the reliability and validity of the seven-item Fullerton Functional Fitness Test (FFT) battery, designed for use with community-dwelling older adults, was examined. The test items were as follows: floor sit-and-reach, back scratch, 8-ft up-and-go, arm curl, 30-s chair stand. 2-min step, and 9-min walk. Seventy-nine participants (42 physically active, 37 sedentary) completed the FFT battery three times within a 2-week period. The test-retest reliability intraclass correlation coefficients were high. Construct validity analysis revealed that five of the seven FFT items discriminated between the physically active and sedentary groups. In conclusion, most of the evidence from the stability reliability and discriminant validity analyses supports the view that the Fullerton FFT battery is a reliable and valid test of functional fitness.

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Juliessa M. Pavon, Richard J. Sloane, Carl F. Pieper, Cathleen S. Colón-Emeric, David Gallagher, Harvey J. Cohen, Katherine S. Hall, Miriam C. Morey, Midori McCarty, Thomas L. Ortel and Susan N. Hastings

This study describes the availability of physical activity information in the electronic health record, explores how electronic health record documentation correlates with accelerometer-derived physical activity data, and examines whether measured physical activity relates to venous thromboembolism (VTE) prophylaxis use. Prospective observational data comes from community-dwelling older adults admitted to general medicine (n = 65). Spearman correlations were used to examine association of accelerometer-based daily step count with documented walking distance and with duration of VTE prophylaxis. Only 52% of patients had documented walking in nursing and/or physical therapy/occupational therapy notes during the first three hospital days. Median daily steps recorded via accelerometer was 1,370 (interquartile range = 854, 2,387) and correlated poorly with walking distance recorded in physical therapy/occupational therapy notes (median 33 feet/day [interquartile range = 12, 100]; r = .24; p = .27). Activity measures were not associated with use or duration of VTE prophylaxis. VTE prophylaxis use does not appear to be directed by patient activity, for which there is limited documentation.

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Lena Fleig, Megan M. McAllister, Penny Brasher, Wendy L. Cook, Pierre Guy, Joseph H. Puyat, Karim M. Khan, Heather A. McKay and Maureen C. Ashe

Objectives:

To characterize patterns of sedentary behavior and physical activity in older adults recovering from hip fracture and to determine characteristics associated with activity.

Methods:

Community-dwelling, Canadian adults (65 years+) who sustained hip fracture wore an accelerometer at the waist for seven days and provided information on quality of life, falls self-efficacy, cognitive functioning, and mobility.

Results:

There were 53 older adults (mean age [SD] 79.5 [7.8] years) enrolled in the study; 49 had valid data and demonstrated high levels of sedentary time (median [p10, p90] 591.3 [482.2, 707.2] minutes/day), low levels of light activity (186.6 [72.6, 293.7]), and MVPA (2 [0.1, 27.6]), as well as few daily steps (2467.7 [617.1, 6820.4]). Regression analyses showed that age, gender, gait speed, and time since fracture were associated with outcomes.

Conclusions:

Older adults have long periods of sedentary time with minimal activity. Results are a call to action to encourage people to sit less and move more.

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Joanna Edel McHugh and Brian A. Lawlor

Background:

Perceived health status does not always reflect actual health status. We investigated the association between objective and self-rated measures of health status and hours of exercise per week in older adults.

Method:

As part of the TRIL clinic assessment, we gathered information from 473 community dwelling adults over the age of 65, regarding hours spent per week exercising, depression, personality, perceived health status, and objective health status (in the form of a comorbidity count). Regression analyses were performed on these data to investigate whether perceived health status, objective health status, personality and mood are associated with hours of exercise per week.

Results:

Perceived and objective health status were significantly but weakly correlated. Both perceived and objective health status, as well as depression, were independently associated with hours of exercise per week.

Conclusions:

We conclude that exercise uptake in older adults is contingent on both perceived and objective health status, as well as depression. Perceived health status has a stronger association with exercise uptake in older adults with lower depression levels. The current findings have implications for designing exercise interventions for older adults.

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Nancy Margaret Salbach, Jo-Anne Howe, Karen Brunton, Kathryn Salisbury and Lorene Bodiam

Background:

The purpose of this article is to describe the development and evaluation of a task-oriented group exercise program, delivered through a municipal recreation program, for community-dwelling people with neurological conditions.

Methods:

Physical therapists (PTs) at a rehabilitation hospital partnered with a municipal recreation provider to develop and evaluate a 12-week exercise program for people with stroke, acquired brain injury, and multiple sclerosis at 2 community centers. Fitness instructors who were trained and supported by PTs taught 1-hour exercise classes twice a week. In a program evaluation of the safety, feasibility and effects of the program, standardized measures of physical function were administered before and after the program.

Results:

Fourteen individuals (mean age: 63 years) participated and attended 92% of exercise classes, on average. Two minor adverse events occurred during 293 attendances. Improvement in mean score on all measures was observed. In people with stroke, a statistically significant improvement in mean Berg Balance Scale (mean ± SD change = 3 ± 2 points, P = .016, n = 7) and 6-minute walk test scores (change = 26 ± 26 m, P = .017, n = 9) was observed.

Conclusions:

This model of exercise delivery provides people with neurological conditions with access to a safe, feasible and potentially beneficial exercise program in the community.